Post-bariatric hypoglycaemia (PBH) is typically a post-prandial hypoglycaemia occurring about 2–4 h after eating in individuals who have undergone bariatric surgery. PBH develops relatively late after surgery and often after discharge from post-surgical follow-up by bariatric teams, leading to variability in diagnosis and management in non-specialist centres.

Aim

The overall aim was to improve and standardise clinical practice in the diagnosis and management of PBH. The objectives were: () to undertake an up-to-date review of the current literature; () to formulate practical and evidence-based guidance regarding the diagnosis and treatment of PBH; () to recommend future avenues for research in this condition.

Method

A scoping review was undertaken after an extensive literature search. A consensus on the guidance and confidence in the recommendations was reached by the steering group authors prior to review by key stakeholders.

Outcome

We make pragmatic recommendations for the practical diagnosis and management of PBH, including criteria for diagnosis and recognition, as well as recommendations for research areas that should be explored.

Plain English summary

Post-bariatric hypoglycaemia (PBH) is a condition that commonly affects people who have undergone weight loss surgery. In this condition, people develop low blood sugar occurring about 2–4 h after meals, leading to debilitating symptoms such as hunger, sweating, anxiety, palpitations and even blackouts and fainting. PBH is becoming more common as weight loss surgery is being taken up by more people to help with their weight and to help with diabetes. The condition often develops after the patient has been discharged from follow-up after their surgery, which can lead to inconsistent diagnosis and treatment in non-specialist healthcare centres. The lack of clear information and evidence in the existing scientific literature further contributes to the variation in care. To address this problem, the Society for Endocrinology has created new guidelines to help healthcare professionals accurately diagnose and manage this condition. The guidelines were developed with input from dietitians, surgeons and doctors specialising in weight loss, and hormone specialists.

中文翻译：

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内分泌学会减肥后低血糖诊断和治疗指南

减肥后低血糖 (PBH) 通常是接受减肥手术的个体进食后约 2-4 小时发生的餐后低血糖。 PBH 在手术后发生相对较晚，通常在减肥团队术后随访出院后发生，导致非专科中心的诊断和管理存在差异。

目的

总体目标是改善和规范 PBH 诊断和管理的临床实践。目标是： () 对当前文献进行最新回顾； () 制定有关 PBH 诊断和治疗的实用且基于证据的指南； () 推荐在这种情况下的未来研究途径。

方法

在广泛的文献检索后进行了范围界定审查。在关键利益相关者审查之前，指导小组作者就建议的指导和信心达成了共识。

结果

我们为 PBH 的实际诊断和管理提出务实的建议，包括诊断和识别标准，以及应探索的研究领域的建议。

简单的英语摘要

减肥后低血糖（PBH）是一种常见于接受过减肥手术的人的病症。在这种情况下，人们会在饭后约 2-4 小时出现低血糖，导致虚弱症状，如饥饿、出汗、焦虑、心悸，甚至昏厥和昏厥。随着越来越多的人接受减肥手术来帮助控制体重和治疗糖尿病，PBH 变得越来越普遍。这种情况通常是在患者术后出院后出现，这可能导致非专科医疗中心的诊断和治疗不一致。现有科学文献中缺乏明确的信息和证据进一步加剧了护理的差异。为了解决这个问题，内分泌学会制定了新的指南来帮助医疗保健专业人员准确诊断和管理这种情况。该指南是根据营养师、外科医生、减肥专业医生以及激素专家的意见制定的。